Published: 2021-05-28

A case control study on the risk factors of non-syndromic orofacial clefts

Joe Thomas, Jubina Bency Anthoorathodi, Gemsy Maria, Femy Jose, Glare George, Harimurali Sreenivasan, Hilal A. Rahman, Joel D. James, Unnikrishnan U. G.


Background: Orofacial clefts (OFCs) are the most common craniofacial malformation of the new born in the world. In India OFCs are the 3rd most common congenital anomaly following anencephaly and club foot. Objectives were to study the association of family history, medications during pregnancy, passive smoking with non-syndromic OFC, and to determine the pattern of OFCs in the study population.

Methods: This is a hospital-based, matched case-control study conducted in a tertiary care centre, Thrissur, Kerala. We interviewed 30 mothers of children affected by non-syndromic OFCs. Mothers were asked about their sociodemographic details and other suspected risk factors using a semi structured questionnaire.

Results: In our study unilateral left sided cleft lip was found to be more prevalent 62%. Those who had a family history of OFCs was found to have a significantly higher risk of OFC (OR 26.333). Medications for diabetes mellitus, hypertension, thyroid dysfunction, bronchial asthma, analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) during first trimester of pregnancy posed a higher risk for OFCs (OR 7.222). Maternal age at pregnancy greater than or equal to 30 was also found to be a significant risk factor.

Conclusions: In our study we found out that family history is a risk factor for OFCs. We conclude that exposure of the mother to passive smoking should be avoided during pregnancy and family members should be made aware of the health hazards of passive smoking. Medications should only be taken after consulting a doctor preferably an obstetrician. Self-medication during pregnancy should be strictly avoided.



Orofacial clefts, Birth defect, Risk factors, Cleft palate/lip

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